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Year 3 > Renal > Flashcards

Renal Flashcards

1
Q

Hemolytic Uremic Syndrome (HUS) (5)

A

Hemolytic anemia

Acute kidney injury (AKI)

Thrombocytopenia

Shiga toxin

E. coli O157

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2
Q

Meds witheld with AKI

A

DAMN drugs:

Diuretics and Digoxin

ACEi or ARBs

Metformin/Methotrexate

NSAIDs

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3
Q

AKI stages for creatine

1,2 & 3

A

1.5-1.9 increase in creatinine → AKI Stage 1

2.0–2.9x increase in creatinine → AKI Stage 2

3x increase in creatinine or more → AKI Stage 3.

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4
Q

Definition and Staging AKI (KDIGO Criteria)

Stage 1,2 & 3

Urine Output Criteria

A
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5
Q

Causes of AKI Pre Renal (3)

A

(DSH)

dehydration

sepsis

heart failure

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6
Q

Causes of AKI (intrinsic) Renal (3)

A

acute tubular necrosis

glomerulonephritis

nephrotoxins like NSAIDs or ACE inhibitors

i.e. direct kidney damage

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7
Q

Causes of AKI Post-renal

I.e. obstruction

(3)

A

kidney stones
enlarged prostate
tumors

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8
Q

Key test to rule out obstruction

A

USS KUB
(post-renal AKI)

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9
Q

Diagnostic criteria in AKI

A

↑ in Creatinine ≥ 50% in 7 days

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10
Q

Key Mx in AKI (DAMN + other)

A

Stop DAMN drugs:

Diuretics and Digoxin

ACEi or ARBs

Metformin or Methotrexate

NSAIDs

&

give Fluid rehydration

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11
Q

CKD, how long does to qualify?

A

> 3 months

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12
Q

eGFR diagnosis for CKD stage 4 & 5

A
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13
Q

ACR diagnosis for CKD

A

ACR ≥3 mg/mmol

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14
Q

G1 (eGFR ≥90) means?

A

evidence of kidney damage, even though the filtration rate is still normal

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15
Q

G5: eGFR <15 means?

A

(End-Stage Renal Disease - ESRD).

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16
Q

eGFR < 30 means?

A

accelerated referral progression

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17
Q

ACR ≥ 70 means?

A

Uncontrolled Hypertension

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18
Q

1st Line Tx BP if ACR >30?

A

ACE/ ARB (ARB if black)

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19
Q

Cause of Anameia

A

Low Erythropoietin

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20
Q

Indic for Acute Dialysis? (5)

A

AEIOU

Acidosis

Electrolytes

Intoxication

Oedema

Uraemia Symptoms

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21
Q

Stage req. for Long term dialysis

A

CKD Stage 5

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22
Q

catheter name in peritoneal dialysis?

A

Tenckhoff

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23
Q

options for Haemodyalysis (2)

A

Tunnelled cuffed catheter (immediate)

Arterio-venous fistula

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24
Q

Types of AV fistula? (3)

A

Radio-Cephalic

Brachio-Cephalic

Brachio-Basilic

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25
Q

Complications of AV Fistula (3)

A

Thrombosis
Stenosis
Steal Syndrome

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26
Q

Usual Renal immunosuppressants (3)

A

Tacrolimus
Mycophenolate
Pred

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27
Q

2 cancers caused by immunosuppressants

A

Skin (SSC)
NHL

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28
Q

Types of Glomerulonephritis
(2)

A

Nephritic Syndrome

Nephrotic Syndrome

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29
Q

Nephritic Syndrome (3)

A

hematuria
mild to moderate proteinuria
hypertension

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30
Q

Nephrotic Syndrome (4)

A

heavy proteinuria (>3.5 g/day)

hypoalbuminemia

oedema

hyperlipidemia.

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31
Q

IgA Nephropathy (Berger’s Disease) Sx (2)

A

episodic hematuria

respiratory infection

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32
Q

IgA Nephropathy (Berger’s Disease) Dx

A

Diagnosis: IgA deposits on kidney biopsy.

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33
Q

IgA Nephropathy (Berger’s Disease) Mx (3)

A

ACE inhibitors
ARBs for proteinuria,

possibly corticosteroids

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34
Q

Membranous Nephropathy causes what?

A

causes nephrotic syndrome in adults

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35
Q

Membranous Nephropathy secondary Ax (3)

A

Hepatitis B
malignancy
autoimmune diseases (SLE)

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36
Q

Membranous Nephropathy which deposits

A

IgG and Complement deposits on membrane

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37
Q

Autoantibodies against glomerular basement membrane, which disease

Exposure to solvents

A

Anti-GBM Disease (Goodpasture’s)

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38
Q

Goodpasture Syndrome (3)

A

Pulmonary issues

Haemoptysis

Anti-GBM Antibodies

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39
Q

Post-Streptococcal Glomerulonephritis (PSGN) (3)

A

Cola-colored urine (hematuria).

Immune complex deposition
(subepithelial humps).

Recent streptococcal infection (e.g., throat or skin infection).

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40
Q

Fever
Rash
Mild Oema

NSAIDS

High BP

Dx and Big buzzword?

A

Acute Interstitial Nephritis (AIN)

White cell casts

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41
Q

Whats is ↑ in AIN

A

↑ Creatine

↑ Eosinophils

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42
Q

Triad of features AIN

A

Triad of

Fever

Rash

Eosinophilia

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43
Q

Diagnostic test for AIN

A

Kidney Biopsy for Histology

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44
Q

Mx for AIN (2)

A

Stop using trigger
Steroids

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45
Q

common cause of Acute Kidney Injury (AKI)

A

Acute Tubular Necrosis

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46
Q

What dies in ATN

A

tubular epithelial cells within the renal tubules

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47
Q

Ischemic ATN Ax (3)

A

Shock/Sepsis

hypotension

hypovolemia/ Deyhdration

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48
Q

Nephrotoxic ATN drugs (3)

A

Aminoglycosides

NSAIDs

contrast agents

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49
Q

ATN Urinalysis (1)

A

Muddy brown granular casts (sloughed tubular cells)

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50
Q

ATN bloods (3)

A

↑ creatinine

↑ blood urea nitrogen (BUN).

↑ FeNa (>2%) =ATN

FeNa <1% = pre-renal AKI

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51
Q

ATN Tx (2)

A

Stop nephrotoxic meds

IV fluids

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52
Q

Renal Tubular Acidosis Type 2 (proximal RTA) is a disorder where the kidneys can’t properly reabsorb XXX in the proximal tubule, leading to YYY.

What is XXX and YYY

A

XXX= Bicarbonate

YYY= Metabolic Acidosis

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53
Q

Main cause of Renal Tubular Acidosis Type 2

A

Fanconi’s syndrome

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54
Q

Renal Tubular Acidosis Type 2 Tx

A

Oral Bicarbonate

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55
Q

What causes Acidosis in:

RTA T1

RTA T2

RTA T4

A

RTA T1= Unable to excrete Hydrogen Ions

RTA T2= Unable to reabsorb Bicarbonate

RTA T4= Reduced action Aldosterone

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56
Q

Renal tubular acidosis type 1 key disease linked?

A

Sjögren’s syndrome (Dry Eyes, and Dry Mouth)

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57
Q

Renal tubular acidosis type 1

Affected Tubule?

K+ ↑ ↓ ?

Urine PH ↑ ↓ ?

bonus buzzword?

A

Distal

K+ ↓

Urine PH ↑

Kidney stones

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58
Q

Renal tubular acidosis type 2

Affected Tubule?

K+ ↑ ↓ ?

Urine PH ↑ ↓ ?

A

Proximal

K+ ↓

Urine PH ↑

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59
Q

Renal tubular acidosis type 4

Affected Tubule?

K+ ↑ ↓ ?

Urine PH ↑ ↓ ↔ ?

A

Distal

K+ ↑

Urine PH ↔

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60
Q

Hemolytic Uremic Syndrome (HUS)
(3)

A

Hemolytic Anemia (MAHA)/schistocytes

Thrombocytopenia

Acute Kidney Injury (AKI): ↑ creatinine levels

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61
Q

Toxin related to HUS

A

Shiga

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62
Q

Shiga comes from which bacteria (2)

A

E.Coli 0157 (main)

Shigella

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63
Q

HUS Tx (3)

A

Antihypertensive meds

Blood transfusion

Dialysis

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64
Q

HUS = HUT

Whats HUT

A

HUS = HUT

Haemolytic anaemia
Uraemia
Thrombocytopenia

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65
Q

2 key buzzwords for HUS

A

Petting zoo/animal contact

Child

66
Q

Who usually gets Rhabdomyolysis

A

elderly people with fall

67
Q

Muscle breakdown products (4)

A

Myoglobin
K+
PO₄³⁻
CK

68
Q

Out of the muscle breakdown products, which are most harmful to kidneys

A

Myoglobin

69
Q

Urine colour in Rhabdomyolysis

A

Red-Brown

70
Q

Why is Urine colour red brown?

A

Myoglobinuria

71
Q

Rhabdomyolysis key Dx

A

CK

72
Q

Rhabdomyolysis Tx

A

IV fluids

73
Q

Hyperkalemia ECG (3)

A

Flattened P waves

Broad QRS

Tall tented T waves

74
Q

What meds cause Hyperkalemia (4)

A

Aldosterone Antagonists

ACEi

ARBs

NSAIDs

75
Q

What commonly causes a false result in Hyperkalemia?

A

Hemolysis while taking the sample

76
Q

What needs monitoring in Hyperkalemia (1)

A

ECG changes

77
Q

Hyperkalemia Tx (elctrolyte imbalance)

A

Insulin + Dextrose Infusion

78
Q

Hyperkalemia Tx (stabilise heart)

A

IV Calcium Gluconate

79
Q

Polycystic Kidney Disease (3)

A

Cysts (in kidneys and sometimes liver)

Hypertension (common early sign, especially in ADPKD)

Autosomal Dominant (for ADPKD; Autosomal Recessive for ARPKD)

80
Q

PKD inheritance pattern?

A

Autosomal Dominant

81
Q

PKD Ix

A

USS

82
Q

PKD findings in:

Brain?

Colon?

Heart?

A

Brain= Cerebral Aneurysms (Subarachnoid haemorrhage)

Colon= Diverticula

Heart= Valve Disease (Mitral Regurg) mitral valve prolaspe

83
Q

Cause of Hematuria in PKD

A

Cyst Rupture

84
Q

Meds to slow down PKD

A

Tovaptan

85
Q

nephrotic syndrome (3)

A

proteinuria (>3-3.5g/day)

oedema

hypoalbuminaemia

hyperlipidaemia

lipiduria

86
Q

Nephritic Syndrome (5)

A

Hematuria (cola-colored or smoky urine)

Hypertension (due to fluid retention)

Oliguria (reduced urine output)

Proteinuria (mild to moderate)

Red blood cell casts (in urine microscopy)

87
Q

Nephritic Syndrome, who usually gets it?

A

Children and Young Adults: Often post-infectious (e.g., post-streptococcal glomerulonephritis).

Middle-aged adults: Conditions like IgA nephropathy or lupus nephritis can present in young to middle-aged adults.

88
Q

Post-Streptococcal Glomerulonephritis , who usually gets it and why?

A

Child (often 5–12 years old) with recent history of a sore throat or skin infection (e.g., impetigo).

89
Q

IgA Nephropathy, who usually gets it and why?

A

Young adult with recurrent episodes of hematuria, often following an upper respiratory infection.

90
Q

Lupus Nephritis, who usually gets it and why?

A

Young female adult with systemic lupus erythematosus (SLE)

91
Q

the most common cause of nephrotic syndrome in children?

A

Minimal Change Disease

92
Q

Focal Segmental Glomerulosclerosis (FSGS) (3)

A

HIV

Segmental sclerosis

Primary or secondary

93
Q

Membranoproliferative Glomerulonephritis (MPGN)
(3)

A

Double-contour (“tram-track”) appearance

Subendothelial deposits

Complement pathway activation

94
Q

Minimal Change Disease (MCD)
(3)

A

odocyte foot process effacement

Selective proteinuria

Responds to steroids

95
Q

Diabetic Nephropathy (3)

A

Kimmelstiel-Wilson nodules

Hyperfiltration injury

Mesangial expansion

96
Q

Membranous Glomerulopathy (3)

A

Subepithelial deposits

“Spike and dome” appearance

PLA2R antibodies

97
Q

IgA Nephropathy (Berger’s Disease) (3)

A

Mesangial IgA deposits

Recurrent hematuria

After respiratory infection

98
Q

Nephrotic Syndrome Buzzwords (3)

A

Massive proteinuria (>3.5 g/day)

Hypoalbuminemia

Edema

99
Q

Nephritic Syndrome (3) Buzzwords

A

Hematuria (red cell casts)

Hypertension

Mild to moderate proteinuria

100
Q

alport (3)

A

eye
ear
urine

affected

can’t pee, can’t see, can’t hear a bee

basket-weave appearance

101
Q

Drugs for:

Ascites:

Heart Failure:

Hypertension:

A

Ascites: Aldosterone antagonists (e.g., spironolactone).

Heart Failure: Loop diuretics (e.g., furosemide).

Hypertension: Thiazide diuretics (e.g., hydrochlorothiazide).

102
Q

ACR>30 + Hypertension —-> start X

ACR>60 ——> start Y

What is X and Y

A

ACR>30 + Hypertension —-> start ACEi

ACR>60 ——> start ACEi

103
Q

type 1 Resp Failure -
type 2 Resp Failure -

A

type 1 - 1 abnormality (low PaO2)
type 2 - 2 abnormalities (low PaO2 and high PaCO2)

104
Q

eGFR = CAGE , what does CAGE stand for

Creatinine clearance = replace the E for what?

A

eGFR = CAGE (creatinine, age, gender, ethnicity)
Creatinine clearance = replace ethnicity with weight

105
Q

streptococcal glomerulonephritis, electron microscopy reveals subepithelial depositions of xxx and yyy?

A

IgG and ↓ C3

106
Q

UTI in Non-Pregnant Individuals

A

Nitro twice daily 3 days

107
Q

UTI in 1st/2nd/3rd Trimester Pregnant

A

Nitro twice daily 7 days

108
Q

eGFR clock main bits

A
109
Q

Urinary tract infection, key bacteria

A

E.Coli

110
Q

NICE Guidelines for Stopping an ACE-Inhibitor

Creatinine increases by >XXX% from baseline.

Potassium rises to ≥ YYYmmol/L, as this increases the risk of dangerous arrhythmias.

A

Creatinine increases by >30% from baseline.

Potassium rises to ≥6.0 mmol/L, as this increases the risk of dangerous arrhythmias.

111
Q

Kidney stone Mx

<5mm:

<2cm:

> 2cm:

A

<5mm: Conservative management with watchful waiting.

<2cm: ESWL or ureteroscopy for pregnant patients or distal stones.

> 2cm: PCNL for large or complex stones.
Failure/Complex cases: Open surgery as a last resort.

112
Q

Epithelial crescents in the glomeruli

A

Rapidly progressive glomerulonephritis, also called cresenteric glomerulonephritis

113
Q

post-streptococcal glomerulonephritis

findings under:

immunofluorescence

electron microscopy

A

immunofluorescence= Starry sky appearance

electron microscopy= subepithelial deposits

114
Q

renal cell carcinoma triad+1

A

haematuria

flank pain

palpable mass

Puo

115
Q

Pyelonephritis (3)

A

Flank pain

Fever and chills

Leukocytes and nitrites (on urine dipstick)

116
Q

Biliary Colic (3)

A

Right upper quadrant pain

Postprandial symptoms (after fatty meals)

No fever (distinguishes it from cholecystitis)

117
Q

UTI (3)

A

Dysuria

Frequency and urgency

Positive leukocytes/nitrites

118
Q

Renal Colic (3)

A

Loin-to-groin pain

Hematuria

Intermittent spasmodic pain

119
Q

Appendicitis (3)

A

Right lower quadrant pain (McBurney’s point)

Periumbilical pain migration

Rebound tenderness

120
Q

Acute Hydrocele (3)

A

Scrotal swelling

Transillumination positive

Painless (or mild discomfort)

121
Q

Testicular Torsion (3)

A

Severe sudden-onset pain

Absent cremasteric reflex

High-riding testicle

122
Q

Torsion of Testicular Appendage (3)

A

Blue dot sign

Localized upper pole tenderness

Normal cremasteric reflex

123
Q

Epididymo-orchitis (3)

A

Scrotal pain/swelling

Positive Prehn’s sign (pain relief when scrotum is lifted)

Cremasteric reflex present

124
Q

‘as a general rule, teratomas more commonly occur in younger/older men,

with seminomas in younger/older men.’

tell me which one

A

‘as a general rule, teratomas more commonly occur in younger men

with seminomas in older men.’

125
Q

When is a nephrostomy indicated (2)

A

Obstructed and infected kidney (e.g., pyonephrosis)

Severe hydronephrosis to relieve pressure

126
Q

When is ESWL (Extracorporeal Shock Wave Lithotripsy) indicated for renal stone (1)

When Cx?

A

Renal stones ≥5 mm (preferred for <20 mm)

Cx Pregnant

127
Q

When is ESWL (Extracorporeal Shock Wave Lithotripsy) indicated for uteric stone (2)

A

<10 mm: Offer ESWL

10–20 mm: Consider ESWL (if clearance likely within 4 weeks)

128
Q

When should a ureteric stent be used?

Pre-treatment (2)

A

Routine stenting not recommended before ESWL in adults

Consider for children with staghorn stones before ESWL

129
Q

When should a ureteric stent be used?

Post-treatment (2)

A

Not routine after ureteroscopy for stones <20 mm, unless clinical need (e.g., infection, obstruction, solitary kidney)

130
Q

When is PCNL (Percutaneous Nephrolithotomy) indicated (2)

A

Renal stones >20 mm

Staghorn stones

131
Q

Bladder cancer 3 buzzwords

A

Transitional Cell Carcinoma (TCC) - The most common histological type.

Cystoscopy - Gold standard for diagnosis.

BCG Therapy - Common intravesical treatment for non-muscle-invasive bladder cancer.

132
Q

What is Cystoscopy gold standard Ix for?

A

Bladder Cancer

133
Q

Orchitis (3 buzzwords)

A

Mumps virus - Most common cause of viral orchitis.

Unilateral or bilateral testicular swelling - Key clinical sign.

Systemic symptoms - Fever, malaise, and parotitis (if mumps-related).

134
Q

Cystine stones, buzzword?

A

Childhood

135
Q

Most common stones?

A

Calcium Oxalate

136
Q

Balanitis (3)

A

Erythema

Discharge (foul smelling)

Diabetics

137
Q

Stress incontinence - 1st Line Tx and Sx Tx

A

1st= pelvic floor exercises.

Surgical Tx = transobturator vaginal tension-free tape.

138
Q

Urge incontinence- 1st Line Tx

A

instruction for bladder training/bladder drill

139
Q

1st Line Tx BPH long term

and short term

A

LT Finasteride

ST doxazosin

140
Q

1st line Tx Overactive Bladder (OAB) with symptoms of urgency, frequency, and urge incontinence.

A

Tolterodine

141
Q

1st Line Tx symptomatic relief of dysuria , in UTIs.

A

Phenazopyridine

142
Q

LUTS associated with BPH Tx

A

Tamsulosin

143
Q

Stress Urinary Incontinence (SUI) in women

A

Duloxetine

144
Q

balanoposthitis (3)

A

Inflammation - Redness, swelling, and irritation of the glans and foreskin.

Infection - Commonly caused by fungal (e.g., Candida) or bacterial pathogens.

Hygiene - Poor genital hygiene is a key risk factor.

145
Q

Family Hx Kidney stones- which type? and Tx

A

Cystine

penicillamine

146
Q

Phimosis (1)

A

Non retractable foreskin

147
Q

Paraphimosis (1)

A

trapped foreskin

148
Q

Peyronie’s Disease (3)

A

Fibrous plaques
Penile curvature
Painful erections

149
Q

Priapism (2)

A

unwanted erection

venous occlusion

150
Q

Radiolucent Stones
(4)

A

Translucent In ur Xray

Tiramterene
Indinavir (HIV)
Uric Acid
Xanthine

151
Q

A semi-opaque stone with a ‘ground-glass’ appearance (1)

A

cystine stone

152
Q

Radiopaque stones (3)

A

struvite

calcium oxylate

calcium phosphate stones

153
Q

treatment for acute pyelonephritis/septic

A

Ciprofloxacin 500mg twice daily for 7 days

154
Q

Calculate Anion Gap

A

Anion gap = (Na + K) - (HCO−₃ + Cl )

155
Q

Transitional Cell Carcinoma (TCC) of the Bladder (3)

A

painless hematuria

smoking

occupational exposure to chemicals.

156
Q

Renal cell carcinoma

A

hematuria

flank pain

palpable mass

157
Q
  • Stone <5mm = should pass spontaneously within 4 weeks of onset
  • Stone <10mm = shock wave lithotripsy (wave to break stone)
  • Stone <10mm + pregnant = uteroscopy
  • Complex renal caculi/staghorn calculi = percutaneous nephrolithotomy (invasive)
  • Hydronephrosis/infection = nephrostomy
A
  • Stone <5mm = should pass spontaneously within 4 weeks of onset
  • Stone <10mm = shock wave lithotripsy (wave to break stone)
  • Stone <10mm + pregnant = uteroscopy
  • Complex renal caculi/staghorn calculi = percutaneous nephrolithotomy (invasive)
  • Hydronephrosis/infection = nephrostomy
158
Q

Urge Incontinence:

What happens

A

You feel a sudden, strong urge to pee and can’t hold it in

trigger=

hearing running water or arriving home (key-in-the-door phenomenon).

159
Q

Stress Incontinence:

What happens

A

Pee leaks out during activities that put pressure on the bladder.

When it happens: Laughing, coughing, sneezing, lifting something heavy.

160
Q
A

Year 3 (4 decks)

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